A Pharma Company Is Sponsoring An iPhone App To Fight The Opioid Crisis It Helped Start


Tech

Purdue Pharma’s blockbuster painkiller, OxyContin, is widely
blamed for setting off the opioid epidemic. Now the company is
starting an iPhone and Apple Watch study that aims to get
patients off their medications.

Posted on March 28, 2017, 17:21 GMT

Darren Mccollester / Getty Images

The pain medication OxyContin has been
widely blamed for setting off the opioid epidemic, one in
which
more than 15,000 people in the United States fatally
overdosed on prescription painkillers in 2015 alone.

Now, the drug’s maker, Purdue Pharma, is starting a study
that asks chronic pain patients to log their symptoms on
iPhones and Apple Watches, so their doctors can keep tabs on
them and, ideally, decrease or eliminate their medications.

Purdue plans to partner with Geisinger Health System in
Pennsylvania,
a state that has been hard-hit by opioid abuse, to
recruit hundreds of patients this summer for a yearlong
study.
Purdue began experimenting with ResearchKit, Apple’s
software framework for clinical trial apps, in 2015. This is
Purdue’s first official foray into remote health-monitoring
technology.

Researchers at Purdue and Geisinger hope that wearables and
smartphones will help doctors better understand patients’
real-time experiences, prescribe them painkillers only as
needed, and cut health care costs. While some public health
experts say the study potentially has merit, they acknowledge
that Purdue’s involvement can, at the very least, look
awkward.

“I’m just very suspicious that they’re interested in
developing a tool that will help people get off of their
medicines,” said Andrew Kolodny, co-director of the Opioid
Policy Research Collaborative at Brandeis University. “When I
hear about this, I wonder if it’s all an effort by Purdue to
get good [public relations].”

Robert Jamison, an anesthesia and psychiatry professor at
Brigham and Women’s Hospital and Harvard Medical School, said
abuse of OxyContin “triggered some of the problems we’re
facing today.” He added of Purdue, “I’m sure they’re looking
for some positive press out of this, [so they can] say,
‘We’re trying to make things better.’”

“I know that sounds like, ‘What a crazy thing for a company
that produces opioids to do,’” Tracy Mayne, Purdue’s
executive director of medical affairs strategic research,
told BuzzFeed News. “But it comes from that level of
commitment to addressing the problem in the US.”

Alex Wong / Getty Images

Family members hold pictures of loved ones killed by the
opioid epidemic during a news conference on Capitol Hill.

Since 1996, OxyContin has generated billions for Purdue. The
private, family-owned pharmaceutical company
aggressively marketed the drug and long held an outsized
market share: Its patent on the original formula didn’t
expire until
2013. In
2007, top executives pleaded guilty to federal
prosecutors’ charges that it had misbranded OxyContin as less
addictive than it actually was and misled regulators,
doctors, and patients about its risks. Purdue was fined

$635 million.
Other
lawsuits have since been filed.

Purdue knew for decades that OxyContin’s painkilling effect
often tapered off hours before the advertised 12-hour mark —
a problem that led many patients to become addicted, the

Los Angeles Times reported last year. With
OxyContin prescriptions falling in the US, the company’s
owners are now using some of the same old marketing tactics,
from patient discounts to seminars training doctors to
prescribe opioids, to push the painkiller in Latin America,
Asia, the Middle East, Africa, and other regions, according
to the
Times.

But Purdue executives say their new ResearchKit study is one
of several efforts the company has made to stem opioid abuse.
They co-sponsored a
prescription-monitoring program in Virginia, so
prescribers can see and make decisions based on patients’
medication history, and granted $1 million to the National
Association Boards of Pharmacy to promote
prescription-monitoring nationwide. They’re working on
non-opioid pain treatments and distributed the CDC’s new
opioid-prescribing guidelines to medical professionals.
They’ve also sponsored studies on why patients hang on to
unused opioids, and the characteristics of Medicaid members
who use opioids. These preliminary studies are being
presented this week at the Academy of Managed Care Pharmacy’s
annual meeting.

At the meeting, Purdue will also present early research about
a multi-faceted treatment program for chronic pain patients
at Geisinger, which involves a three-day educational seminar,
a year of follow-up, and coordination and goal-setting with
primary care doctors.

For the new ResearchKit study, the health system plans to
digitize this program by handing out Apple Watches and
iPhones to more than 200 patients. Eligible patients will
have chronic pain conditions like back pain, advanced
osteoarthritis, and rheumatoid arthritis, and will already
routinely take painkillers, Mayne said. (Geisinger did not
make a doctor available to comment on the study.)

The devices will passively record metrics like physical
activity, heart rate, sleep quality, and GPS data (not a
patient’s exact location, Mayne said, but a measure of how
far they’re moving outside their home). Patients will also
self-report information like how much pain they’ve felt that
day or at a given moment, how depressed they feel, and how
much medication they’re taking.

All this information will be integrated into the patient’s
electronic medical record and shared with their doctor at
Geisinger. Both sides will be encouraged to constantly
communicate with each other about what is and isn’t working,
via text, email, phone, and the app itself.

One data-based recommendation a doctor could make, according
to Mayne: A patient who was averaging 1,000 steps a day, and
is now doing 5,000, should aim for 10,000 steps six months
down the road. Another doctor might observe that a patient’s
pain is lessening as their medication doses decrease,
something that they may not necessarily know when a patient
is going about their life outside the clinic.

“The goal is to be able to reduce reliance on pain
medications, and for some patients, that would absolutely
include complete discontinuation,” Mayne said. “I don’t
expect that to be a large group… but certainly a goal is if
someone can actually discontinue medication.”

John Moore / Getty Images

Jamison says the study “sounds like a real good plan.” He and
his colleagues have conducted a similar, forthcoming study in
which pain patients communicated with their doctors through
an app — for both iOS and Android — and tracked their
activity through a wearable device, in this case a
Fitbit.

That study involved 100 or so people and lasted about three
months, while Purdue and Geisinger intend to run theirs for a
year in a bigger group of patients. In addition to the
200-person Apple Watch group, researchers will study 200
people who have gone through Geisinger’s specialized pain
treatment program in person; 400 enrollees who are in
Geisinger’s pain clinics but not its specialized treatment
program; and a control group of 600 to 800 pain patients.

Sustaining patient enthusiasm over a year will be the main
hurdle, Jamison says. Based on his experience, he said,
“People will use it for a while, and then they’ll drop off
unless they have some sort of sense that ‘this information is
very, very valuable and is going to make a difference in my
care.’”

He added of Purdue: “I gotta believe they’re sincere.”

Still, Kolodny doubts the experiment will give doctors more
useful data than they already have, or actually help curb
addiction.

“Getting patients off of opioids is very difficult,” he said.
“Just because a prescriber recognizes a patient should come
off, doesn’t mean the patient’s going to be capable of it.”

Stephanie Lee is a senior technology reporter for BuzzFeed
News and is based in San Francisco.

Contact Stephanie M. Lee at stephanie.lee@buzzfeed.com.


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